Jan. 06, 2010 - Issue #742: Daybreakers
Two sides to every story: Risk may be low, but Gardasil shots not 100 percent safe
It's an honour to have had Dr. James Mansi respond to my comments on
vaccination in a letter I sent to the Edmonton Journal on December 7. And
it's no surprise that in Mansi's December 18 response he reminds us that
Gardasil is the new standard of care for cervical-cancer prevention, and
urges us to discuss the issue with our doctors. As a Merck employee, it's his
job to do so, as it is the job of our doctors to comply with standards of
care. All of which works better for Merck than it does for many of us.
Dr. Mansi's advice does nothing to alter other relevant facts, however. Even though HPV has been established as a cause of cervical cancer, it is nowhere near the only one. An August editorial in JAMA: the Journal of the American Medical Association, reminds us that while HPV is present in most cases of cervical cancer it is only one of many possible causes, and that prevention is much more complicated than a single vaccine.
The truth is that there are more than 100 different types of HPV, and at least 15 of them are considered cancer-causing. Gardasil targets only two of the cancer-causing strains. The truth is that the relationship between infection at a young age and development of cancer 20 to 40 years later is not known. The truth is that HPV, according to the JAMA piece, does not appear to be very harmful because almost all HPV infections are cleared by the immune system.
Nor should industry-driven standards of care be cause for us to ignore other key dissenting voices, such as that of ABC's Chief Medical Officer Dr. Timothy Johnson. He, last I heard, was clear that he doesn't recommend the shot for its intended population of young girls.
Dr. Diane Harper herself, who worked on the development of the vaccine, has said she's not at all comfortable giving it to girls as young as it is now being given to. And speaking at the Fourth International Public Conference on Vaccination in Virginia in October, she reminded her audience that incidence of cervical cancer in the developed world is low, that four out of five women with cervical cancer are in developing countries, that there have been no efficacy trials in girls under 15 years, and that the rate of serious adverse events is a major concern.
The reason for her honesty, she said, is that she needs to be able to sleep at night, and I stand by the statement I made in my letter to the Journal: we need more scientists, editors and publishers who value their integrity this much.
Repeated reassurances that reported adverse reactions haven't been proven linked to the vaccine do little to reassure the families and young women who have been harmed. Proof means little when your own personal truth is that a week ago you had a healthy daughter and now you no longer do. Dr. Scott Ratner told CBS his daughter was so ill with the autoimmune disease that came in the wake of her first Gardasil shot that she'd have been better off getting cervical cancer than the vaccine.
I understand that the kinds of reactions being reported also occur at a low background rate apart from vaccines. But one in every 1855 Gardasil shots is followed by an adverse reaction report, significant numbers of which are serious, and it is well-known that adverse reactions are seriously under-reported.
As I've written before, I understand that the risks with the vaccine, as with cervical cancer, are small. But they're very real. Some, such as Guillain-Barré or anaphylactic shock can be permanently debilitating or fatal. And reactions are happening now, to young girls not even yet sexually active, in the hopes we might prevent cervical cancer two or three decades from now.
I know Dr. Mansi is just doing his job, but shouldn't full risk-disclosure also be part of the job? Does it really make sense to close our eyes and ears to many inconvenient truths just because a Merck employee has told us to? V
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